Information
This document will be completed by the SE or Contractor "Person in Charge". It will be discussed with the customer, other contractors and all the persons involved in the activity. When completed it will be communicated and signed by all persons involved in the activity before any work starts.
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Please press the arrow above or simply swipe to continue.
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Date and time
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Site location
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Customer
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Internal emergency number
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External emergency number
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Fire extinguishers locations
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Details of emergency plan:
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All hazards/ Risks will be detailed here:
- Chemical risk
- Confined space
- Contractor safety
- Cranes & hoists
- Driving
- Electricity
- Energy efficiency
- Ergonomics
- Fire
- Health
- Hot substances
- Machine safety
- Material handling
- Pollution
- Powered Industrial Trucks
- Production
- Slips, trips & falls
- Travel
- Waste
- Water
- Working at heights
- Sharp objects
- Sharp objects
- Slips, Trips & falls
- Travel
- Water
- Working at heights
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What control measures were implemented?
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IMPORATNT! If the hazard cannot be controlled DO NOT PROCEED.
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All Persons involved in the activity must sign this document to verify that the contents re fully discussed, agreed and understood by all.
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Singee I
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Signee II
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Signee III
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Signee IV
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Signee V
